| Adolescent Child Day Treatment | |
|
1220 S Trenton Ave Tulsa OK 74120-5421 | |
| (918) 582-2131 | |
| (918) 588-8822 |
| Full Name | Adolescent Child Day Treatment |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 1220 S Trenton Ave, Tulsa, Oklahoma |
| Authorized Official Name and Position | Saunya D. Moore (CFO) |
| Authorized Official Contact | 9185822131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Adolescent Child Day Treatment 1620 E 12th St Tulsa OK 74120-5407 Ph: (918) 582-2131 | Adolescent Child Day Treatment 1220 S Trenton Ave Tulsa OK 74120-5421 Ph: (918) 582-2131 |
| NPI Number | 1548573348 |
|---|---|
| Provider Enumeration Date | 07/21/2010 |
| Last Update Date | 10/31/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548573348 | NPI | - | NPPES |
| 374021 | Other | OK | MEDICARE PROVIDER NUMBER |
| 100738360B | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 2261 (Oklahoma) | Primary |
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